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Information about uterine fibroids
Minimally Invasive Therapy Unit & Endoscopy Training Centre
University Department of Obstetrics and Gynaecology
Royal Free Hospital
Pond Street
Hampstead
London NW3 2QG, UK |
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Laparoscopic hysterectomy
Laparoscopic
hysterectomy is
a recent operation which was first described
in 1989. It is the equivalent of laparoscopic
myomectomy in terms of approach and
the instruments used; typically, surgery
starts using the laparoscope and miniature
instruments inserted through the abdomen,
and the hysterectomy is completed through
the vagina. If appropriate, ovaries
are easily removed at the same time.
Laparoscopic
hysterectomy is a slow procedure, just
like laparoscopic myomectomy. Recovery,
however, is relatively fast, and comparable
to vaginal hysterectomy. The complication
rate is also generally considered to
be similar.
PROS
Small
external scars only
Can deal with scar tissue or ovarian problems
Subtotal hysterectomy relatively simple
Complications usually less likely than with abdominal hysterectomy
Relatively fast recovery>
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CONS
Not
suitable if the fibroids are very
large
Surgery can take several hours
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MEDICAL NOTES
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Operative laparoscopy
With the aid of small instruments, laparoscopy can also
be used to perform surgery formally done by laparotomy
(large incision). Laparoscopic procedures are usually
associated with shorter hospital, less discomfort and
faster recovery.
Indications for laparoscopic surgery include conditions
such as endometriosis, adhesions, ovarian cysts, tubal
disease. Laparoscopy can also be used to excise fibroids;
as with hysteroscopic myomectomy, this route of surgery
is only indicated providing the fibroids are not over
large or too numerous, and situated mainly on the outside
of the uterus.
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